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General NPI Number Information
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NPI Number | 1417085838
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Entity Type | Individual
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Provider Name | NELS O EWOLDSEN DDS
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 944 COUNTRY CLUB RD
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City | YORK
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State | PA
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Zip | 17403-3438
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Country | US
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Telephone | 717-849-4597
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Fax | 717-849-4515
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Provider Business Mailing Address
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Address Line | 944 COUNTRY CLUB RD
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City | YORK
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State | PA
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Zip | 17403-3438
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Country | US
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Telephone | 717-849-4597
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Fax | 717-849-4515
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS035348
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 938
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5947
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12007599A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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